Patient behaviors

[YoungLPN94]

I work in LTC with geriatric patients, I've had incidents where I've been hit by residents and it usually doesnt faze me. But recently I was screamed as and hit, also water thrown at me while trying to bring a resident her pills. I had asked her earlier what time and she agreed to the time. When I arrived she wanted to keep the pills on her bed and take them later. I nicely asked her to please return the pills as it is against policy for nurses to leave pills with residents. At this point she started to yell and hit me. When speaking to her with another staff present 30 minutes later, the resident agreed that yes she did hit me and she was not sorry, that we cant control her. Keep in mind I had used a very gentle approach with this resident.  Looking for some advice on how not to take incidents like this personal and how I can keep these incidents from happening in the future. Thank you

 

[JKL33]

YoungLPN94 said:

Looking for some advice on how not to take incidents like this personal

Look at the situation from a bird's eye view, and ask yourself why would one take this personally. I mean this kindly, but if you have been personable and professional, why would this resident's behavior have anything to do with you personally? Logically it is far more likely to be related to myriad factors that have zero to do with you, such as this person's personality, life experiences, chronic health conditions, feelings about living in a care facility, etc.

You have to see yourself as being separate from patients and their problems. We are not responsible for patients' problems, meaning we are not the cause of them; rather we are there to do what we can to ease some of them. That is all. Knowing this you can set out to be kind, pleasantly professional and also confident.

 

[Davey Do]

Often times in the geriatric population, explosive behaviors are the result of the brain producing too much of one of the dopamine neurotransmitters.

Given this concept, the individual has little or no control over their explosive behaviors. Antipsychotics- dopamine antagonists- help with these behaviors, such as Haldol, Zyprexa, and Risperdal to name few.

Anticonvulsants such as Depakote, Tegretol, and Lamictal, again to name a few, are often prescribed as mood stabilizers and for explosive disorders.

On many occasions, I've known psychiatrists to prescribe a low dose of an SSRI (e.g. Lexapro, Zoloft, etc.) along with a low dose antipsychotic for an agitated-delusional process.

And finally, there are always the benzodiazepines (Ativan, Clonazepam, etc.) which are effective for agitation.